Women Less Likely to Recognize, Report Heart Attack Symptoms

February is American Heart Month, and on February 3, we celebrate National Wear Red Day® to draw attention to women's heart health.

Doctor writing an EKG signal

Some people might ask why we need a separate day to draw attention to women's heart health issues. Aren't hearts pretty much the same, regardless of a person's gender? The answer, we now know, is no—and yet in the past, most research focused on male subjects. Researchers didn't realize at the time that the causes, risk factors, treatment and even symptoms of heart attack and other cardiovascular conditions could be quite different for female patients.

Surveys also showed that many women had misperceptions about their risk of heart disease. Many thought they were at higher risk of dying from breast cancer—even though, according to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for women. Most women were unaware that heart attack could strike young women. And when women experienced symptoms of heart attack, they often attributed them to indigestion, a pulled muscle or an anxiety attack. Rather than seek immediate medical attention, they were likely to research their symptoms online or talk to a friend.

To remedy this information gap, health organizations have been working together to raise awareness of heart health among women. What should women know about heart disease?

Let's start with the symptoms. According to the CDC, women may have heart disease with no noticeable symptoms. Others might experience vague symptoms. The CDC says not to ignore symptoms such as …

  • Chest pain or discomfort; pain in the neck, jaw or throat; upper back pain; indigestion; heartburn; nausea and vomiting; extreme fatigue; upper body discomfort and shortness of breath, all of which may be warning signs of a heart attack.
  • A fluttering feeling in the chest, which might mean that a woman is experiencing arrhythmia.
  • Shortness of breath; fatigue; swelling of the feet, ankles, legs or abdomen, which might be signs of heart failure (a condition that happens when the heart cannot pump enough blood and oxygen to support other organs of the body).

As you can see, some of these symptoms could easily be attributed to other causes—and a busy woman might be tempted to dismiss them. For example, a cardiologist from Houston Methodist recently warned women that the stress of the holidays increases the risk of heart attack, and ironically, a woman might chalk up heart attack symptoms to the stress and anxiety of this busy time.

The American Heart Association (AHA) concurs that the symptoms of heart attack are different for women. In 2016, the AHA released the first scientific statement on heart attacks in women. They shared the good news that the rate of cardiovascular death in women has declined due to improved treatment, prevention and public awareness—but warned that women still have a long way to go. Said researcher Dr. Laxmi Mehta, Director of the Women's Cardiovascular Health Program at The Ohio State University, "Despite stunning improvements in cardiovascular deaths over the last decade, women still fare worse than men and heart disease in women remains underdiagnosed, and undertreated."

Women also should educate themselves about the causes, treatment and risk factors that are common in women:

Causes. The AHA says, "Heart attacks caused by blockages in the main arteries leading to the heart can occur in both men and women. However, the way the blockages form a blood clot may differ. Compared to men, women can have less severe blockages that do not require any stents [a tiny mesh tube that props open an artery]; yet the heart's coronary artery blood vessels are damaged, which results in decreased blood flow to the heart muscle. The result is the same—when blood flow to the heart is decreased for any reason, a heart attack can occur."

Treatment. The AHA warns, "If doctors don't correctly diagnose the underlying cause of a woman's heart attack, they may not be prescribing the right type of treatments after the heart attack." Women also face a greater risk of complications during the attempt to restore blood flow after a heart attack. Their blood vessels are smaller, they tend to be older, and they are more likely to have health conditions that complicate their care, such as diabetes and high blood pressure (hypertension). Women are less likely to be prescribed or to take the recommended medications. And they're less likely to take part in cardiac rehabilitation, a program of exercise, counseling and education to lower the risk of another heart attack.

Risk factors. Many risk factors pose more of a threat for women. High blood pressure is more strongly associated with heart attacks in women, and women with diabetes have a four to five times higher risk of heart disease than do diabetic men.

Dr. Mehta reported that more than 6 million women each year develop coronary heart disease, and as the leading threat to the lives of women, it should be a public health priority. She said, "Women should not be afraid to ask questions—we advise all women to have more open and candid discussions with their doctor about both medication and interventional treatments to prevent and treat a heart attack."

Health Organizations Celebrate Women's Heart Health

The Heart Truth logo

The National Heart, Lung, and Blood Institute sponsors The Heart Truth® to raise awareness about heart disease among women.

Visit the American Heart Association's National Wear Red Day page to find more women's heart health resources and information about the Wear Red Day event.

The Centers for Disease Control and Prevention (CDC) offers consumer resources to promote women's heart health.

The Heart Truth® logo is a registered trademark of the U.S. Department of Health and Human Services.


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